The NHS Counter Fraud Authority (NHSCFA) has been launched, to replace NHS Protect. Its mission is “to lead the fight against fraud affecting the NHS and wider health service, and protect vital resources intended for patient care”. It claims controversially that fraud by dentists amounts to over £70million.
The new authority has been given the independence it needs to fight and deter the fraud, bribery and corruption attacking the NHS. NHSCFA employs specialists in intelligence, fraud prevention, computer forensics, fraud investigation, financial investigation, data analysis and communications - all working together to detect, reduce and deter economic crime targeting the NHS. NHSCFA’s work starts with a focus on five areas. It will:
The BDA has warned that figures published by the new Authority point to chaos within the contract system and could risk giving a wholly misleading picture of fraud within NHS dentistry. Numbers appear to recycle claims made by predecessor body NHS Protect based on a small sample in 2012 that suggested that dental fraud may have cost the NHS £73.1 million in 2009-10.
The BDA has pointed to the impact of the widely discredited 2006 NHS dental contract, which has left numerous grey areas and generated confusion among both patients and practitioners, and urged government to honour pledges on reform. The five year old figures do not appear to distinguish fraud from cases of incorrect claiming from dentists due to numerous grey areas in the existing NHS contract. The BDA has consistently called for clarity on how dentists should claim, but so far none has been offered.
The new authority has also suggested that patients falsely claiming exemptions from NHS dental charges is a major source of fraud. The BDA has recently revealed that fines are often hitting vulnerable patients, with freedom of information requests showing that 9 out of 10 appeals are won. The Association has cautioned that a heavy handed approach could discourage patients who are fully entitled to claim.
Henrik Overgaard-Nielsen, the BDA's Chair of General Dental Practice said: "We condemn any action that takes resources away from our patients. Genuine fraud must be exposed, but we are working under a discredited contract system that breeds confusion. Put 10 NHS dentists in a room and you'll get nearly half a dozen different views on how to claim for a treatment. It's an insane system, and not even officials can navigate the grey areas. For over decade this model has failed patients and practitioners alike, and we need Ministers to honour their pledges and deliver real clarity."